I got a call today from a care provider, asking this: "Once a caregiver has traveled to another country and returns, do they have to get a new TB Test?"
This care provider was diligent in researching the online AFH rules, but could not find the answer to this question there. So she called me. Mind you, I'm not actively teaching for the State of Washington ADSA anymore - and I do not know if they have recently updated the TB testing rules.  But here's my take on this and any other AFH Licensing rule question. 

Understand that if you have read through all the rules, and your question is clearly not addressed, you have several options:
1.  You can assume that there is no specific rule regarding this specific issue, and do nothing - just let it go.
2. You can contact your licensor and ask the question - and then expect to see a new rule update regarding your specific question within a year (do you really want more and more detailed regulations?)
3.  You can contact local health care authorities or other local businesses for recommendations as to best practice in how to proceed,
and make a pro-active decision.  In this case, I might choose to require another TB test, even though the Licensing rules only require testing "upon hire". 

My Recommendation
Pick number 3.  If you've already been through the rules at length, and can find no reference to your specific question, be pro-active as a business owner.  Ask yourself, "What is the desired outcome?"  The answer will always be - to keep my residents well and happy, to follow the licensing rules, and to do good business.  

So - dear care provider - unless you like being tied up very tightly with more and more regulations about every detail on how to run your business - just be pro-active and make the right decision in protecting your residents.   YOU ARE THE BUSINESS OWNER.  YOU ARE RESPONSIBLE for everything in your business. It's not just about the rules.  It's about doing good business.

If you suspect that a caregiver may have come in contact with active TB, and you allow that caregiver to work without a TB test, and your residents' health becomes affected... yes, you would be held accountable for that business decision in one way or another. 

So - make "best practice" decisions and thrive in the business! 

Jo Lyn
"Enough with SEIU’s self-serving political power-grabbing initiative"

THE OLYMPIAN | • Published August 23, 2011

"The bait-and-switch arguments of Service Employees International Union and its beneficiaries in support of Initiative 1163 – in and out of state government – are getting tiresome.

The latest comes from Brendan Williams, a former state representative who now works as a deputy in the Office of the Insurance Commissioner.

In a recent column in The Olympian, Williams claims that the 2011 Legislature “ignored” the public’s will by refusing to fund Initiative 1029. This SEIU-sponsored measure claimed to protect vulnerable adults by requiring a longer, watered-down training curriculum (a more efficient example of which is already in place) and background checks (which are already mandatory). What it actually would have done is provide redundant jobs for union members and a source of new, dues-paying members to fatten SEIU 775’s coffers.

There’s no mention, either in the language of Initiative 1029 or Williams’ opinion article, of how SEIU proposes to pay the $80 million biennial price tag for this measure.

So the Legislature did no such thing as “ignore” the public’s will. A majority of legislators recognized Initiative 1029 for what it is – a cynical SEIU power grab – noted that it had no funding mechanism, and tabled it.

In a period when the state is taking desperate measures to close a yawning $5 billion budget gap, SEIU’s selfish, cavalier approach to the current budget crisis is unconscionable. Whose school lunches does Williams intend to cut to pay for this? Whose taxes does he intend to raise?

In his opinion article, Williams is forced to reach back 15 years to justify “actions” taken in 2011.

Yes, there were tragic examples of resident mistreatment, and all good adult family home operators supported the bad actors being shut down. But so much has changed in the state – in this industry – that dredging up what happened 15 years ago to justify a modern-day initiative is like demanding modern bidding reforms to stop Teapot Dome.

And even in those tragic cases, training (as today) wasn’t the issue. It was about the Department of Social and Health Services’ lack of timely, effective oversight of rogue operators."

I returned my Wisteria Gardens AFH license to my licensor today. 
No, I'm not frightened of the future. 

I'm listening to the inner spirit - and find myself calm and peaceful.

Stillpoint, in CranioSacral Therapy, is a temporary stopping of the craniosacral rhythm.  Simple to induce, it is refreshing to experience.  Once you're in it, you can rest deeply and peacefully.  Then, when the body is ready, the rhythm begins again spontaneously, and you are up and going, refreshed and ready for what the new day will bring. 

One of my personal development trainers taught me that some structures need to be completely dismantled before something else can be built in its place.  That was so true for me, regarding my Adult Family Home.  I've known care providers who sold their homes.  And I did try to do that.  But forces beyond my control conspired to require a closing of my direct care business... before I could be free enough to create our next business. 

The spirit inside me whispers "Peace, be still"...  "All is well"... and "Be still, and know that I am God".   That's why I'm calling this "Stillpoint Serenity."  

God does have a plan.  All of us are in His hands.  And all things work together for our good, as we try to follow His ways. 

Soon, very soon, the rhythm will begin again, and I will be refreshed and ready to meet it, and direct it, and share it. 
Jo Lyn

Just want to make sure you know that my contract for teaching for the State of WA DSHS has come to an end, as it has for many of our WA State independent trainers, as the state makes changes. 
It appears that caregiver training has become a very political issue.  I still get calls, however, from clients and students who want business coaching and specific guidance.  I can still teach you Care Home Business Strategy, I just don't have authorization to give you a Wa State sanctioned certificate for that. 

If you're looking for WA State caregiving classes, I think your best shot is to connect with Robin VanHyning.  She accomplished what I'd been asking the state permission to do for years... getting the trainings online and approved by the state.  She also has trainers in local areas of the state for the hands on skills testing.  

Here's her contact information: (Please do tell her I sent you!)
Contact: Robin VanHyning
Phone: (360) 317-4529
Fax: (510) 280-9023
Email: chtcompany@gmail.com
Company website is www.CHTCompanyOnline.com
Classroom website is www.chcc.digitalchalk.com

Many thanks to you for connecting with me and for the work you do in providing quality care in your Adult Family Home. 

Jo Lyn

Just read an article discussing this politically hot issue.  If you're in the long term care industry in WA State, it's a must read.  Here's the link:
Besides being an AFH trainer since 1996, I have my own AFH - and yes, after 5 years living in as owner/operator, burnout took me out in a big way. I became so ill that I doubted my ability to survive.I never expected that stress would get me down...  after all, I am a nurse, a trainer, and I thought I was doing everything "right". 
You know the statisticians tell us that @ 90% of illnesses are stress related, but they don't tell us what to do about it or how to prevent it. Many people feel that they are somehow "lacking in character" if they
experience burnout. 

A basic awareness of the different kinds of stress and the cellular physiology of how our bodies react to stress is the first critical step in combating it.  Then, there is a five step process that I teach on how to stop stress in it's tracks, and regain good health. Even better news is that there are specific ways to prevent burnout from happening in the first place, and a special approach you can take to keep the energy in your home peaceful and nurturing - even in crisis.

Don't let burnout get you down.  There's ways to heal, and even to prevent it.  Contact me for more information.
2011 brings new caregiver training requirements for the State of Washington for Individual Care Providers, Adult Family Home Care Givers, and Assisted Living Care Givers.  Here's information from the state to Community Based Educators - like me: Can Community Instructors Provide Continuing Education Training to Individual Providers?
Here's a great post from my Linked In Group - full of wisdom that can be applied to Adult Family Homes as well as other businesses.  An AFH is a local business - but everyone's looking online first - so creating a web presence is important - but so is being personable in your community.
"February 16, 2010
Dear Providers:
Recently the Seattle Times newspaper published a series of articles on Adult Family Homes. (You can find the articles at http://seattletimes.nwsource.com/html/seniorsforsale/2010963980_seniors03.html.) From what we understand, there may be more follow‐up articles in the future. The series of articles were not favorable to our industry. They depicted some serious and heart‐wrenching cases of abuse by Adult Family Home (AFH) providers
"There have been questions raised about whether or not a home/facility can release information to the U.S. Census Bureau.  The following is the answer from Irene Owens, DSHS, Office Chief, Policy Unit, Residential Care Services: